So last night was the premier of a new medicine themed TV show called “Monday Mornings” in TNT. Its based on a book written by CNN’s medical correspondent, Sanjay Gupta. From many years of experience I have learned to tune these shows out. They are always over dramatized and the information in them is often grossly inaccurate. They create ridiculous expectations in patients, even those who claim to know “its just a TV show” and they paint physicians as either all powerful gods or completely bumbling boobs. I won’t even discuss the never ending sex in the broom closet.

The title of this show refers to the tradition in this particular hospital of holding morbidity and mortality conference on Monday mornings. For those who are not familiar, in the real world M&M conference as it is referred to is a conference in which selected cases are discussed in order to review the care given. Unlike the image portrayed in this silly show, it is not limited to surgeons ( At one point an internist laments that he would love to go and a surgery resident tells him he would have to become a surgeon). In the show they use the conference to humiliate, dress down, and expel a physician who is laughingly referred to as 007 “licensed to kill”. In real life the purpose of M&M conference is not to embarrass or humiliate anyone. In fact this is counterproductive since the whole reason for the conference is to get physicians to be as honest about the case as possible to see if we can learn anything from them that would help us do better the next time. I guess that doesn’t make for good drama though.

That was just one of the many flaws in the show. The characters are all predictable. You have the older attending who is too full of himself to listen to the young resident who disagrees with him and is ultimately right. Then there’s the surgical resident who falls into a diagnostic trap only to be corrected by the older brilliant surgeon who takes 5 seconds and one look at the patient and diagnoses a ruptured aneurysm saving her life.

Even though I hate these shows for their stupid dialog, inaccurate portrayals and the way they create ridiculous expectations I often watch the first show of a new series. Part of me hopes someone will write a good medical show. Often I think its just that unavoidable urge to look when there is a wreck on the side of the road. Even though he is a physician and should know better it seems Dr Gupta drove this show right over the cliff.

For the record, the closest thing to an accurate medical show I have seen in years is Scrubs. Its silly at times but entertaining and for the most part pretty accurate. House , Chicago Hope, Grey’s Anatomy and ER were all garbage.

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For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

I hear you. If only they weren’t so formulaic I might be able to tolerate the occasional snapping of the reality suspenders. But there’s (rarely) anything new.

Anyone recall an all to brief show called Century City? It was a legal drama set in the future. Had some interesting topics… Like a fellow who had a ‘bionic eye’ and was being blocked from playing baseball because it allegedly gave him an advantage. There was also an episode where a band were suing one of their members because he wouldn’t take the ‘age stopping’ treatments. My wife and I enjoyed it but it

Take care,

Derek

P.S. This reminds me of a conversation I had with a former police forensic investigator whose litany of wrongs about crime scene investigation shows was quite informative.

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“It is noble to be good; it is still nobler to teach others to be good—and less trouble.”—Mark Twain

Gotta agree with both of you. I find the medical shows unrealistic and the forensic shows unwatchable for the same reason. Besides, they all adhere to a common formula which excludes character development. All the CSI shows I have watched, which is not many, had no interesting plot developments: they excluded the characters in favor of mystery hooks. That and they are photographed way too dark.

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You cannot have a rational conversation with someone who holds irrational beliefs.

For the record, the closest thing to an accurate medical show I have seen in years is Scrubs. Its silly at times but entertaining and for the most part pretty accurate. House , Chicago Hope, Grey’s Anatomy and ER were all garbage.

For the record, the closest thing to an accurate medical show I have seen in years is Scrubs. Its silly at times but entertaining and for the most part pretty accurate. House , Chicago Hope, Grey’s Anatomy and ER were all garbage.

Scrubs is the most accurate?

That’s surprising; How about “Doc Martin”?

Scrubs is a comedy obviously so there is some exaggeration for effect but the medicine in the show, the way they portray residency and the story lines is far closer to real life than anything I’ve ever seen in any of those other shows. The characters are much more realistic except where they are intentional caricatures ( ie. the chief of medicine). Medical residents in the show actually do what medical residents do in real life and surgical resident do what surgical residents do in real life. In most shows resident duties are whatever they need to be to fulfill the story line and bare no resemblance to real life. You often see a single resident performing the duties of a internal medicine resident, a surgery resident, a radiology resident, and an oncology fellow. Viewers may like these heroic, able to do anything doctors but it just silliness when you’ve been there and done that and realize how impossible that would be.

The other thing thats always funny is that the doctors spend entire days or weeks taking care of one or two patients. But if you’re going to visit the patients home and family to get clues that will help them treat the patient and still have time to sleep with a couple of nurses and save the world we can’t expect them to actually see the 20 or so patients in a day that a real doctor has to see if he is going to keep the lights on and pay the staff.

I’ve never actually seen Doc Martin. I had never heard of it until a few months ago when a friend brought it to my attention. I understand its a British show about a doc in a small town. I’ll have to see if they have it on Netflix when i get a chance.

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For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

In real life the purpose of M&M conference is not to embarrass or humiliate anyone. In fact this is counterproductive since the whole reason for the conference is to get physicians to be as honest about the case as possible to see if we can learn anything from them that would help us do better the next time. I guess that doesn’t make for good drama though.

I’ve gone to M&Ms;, you always learn something from them. I’ve never seen that show, and it horrifies me to thing Gupta would leave that impression on the naive public.

For the record, the closest thing to an accurate medical show I have seen in years is Scrubs. Its silly at times but entertaining and for the most part pretty accurate.

I loved that show, the nurses actually did nursing care. Especially the show where after an error, the doctors reminisced about who helped them to get where they were as professionals. The experienced nurses figured prominently—as they do in most teaching hospitals.

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Church; where sheep congregate to worship a zombie on a stick that turns into a cracker on Sundays…

I loved that show, the nurses actually did nursing care. Especially the show where after an error, the doctors reminisced about who helped them to get where they were as professionals. The experienced nurses figured prominently—as they do in most teaching hospitals.

I agree. The nurses were much more realistic in that show than most others. They were normal people and the interactions they had with the residents were much more realistic in the sense that they were part of the teaching staff that the residents learned from rather than just being potential sex partners.

For the record, Gupta is not as bad as Oz but he’s getting there. He definitely seems to be more concerned about his future as a media personality than he does about his career in medicine. You can see these doctors transition to the dark side when they start pandering to the public. They’re more concerned with telling people what they want to hear instead of the things they need to hear but may not want to told. They become fearful of shooting down any popular health fad ( organics, antioxidants, the latest diet, Vitamin D , vaccine fears etc. ) because it will cost them viewership. At that point they’ve put their fame and popularity ahead the best interest of their patients/viewers and they really should trade in their MD degree for a press pass. A year or so back Gupta had an article on CNN where he actually gave some support to the whole vaccine/autism nonsense. He didnt actually come out and support it directly but he left it out there as a possible explanation because he clearly didnt want to offend any of his readers. I think he has a bit more respect for science and reason than Oz but he is treading dangerously close to the line there.

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For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

For the record, Gupta is not as bad as Oz but he’s getting there. He definitely seems to be more concerned about his future as a media personality than he does about his career in medicine. You can see these doctors transition to the dark side when they start pandering to the public. They’re more concerned with telling people what they want to hear instead of the things they need to hear but may not want to told. They become fearful of shooting down any popular health fad ( organics, antioxidants, the latest diet, Vitamin D , vaccine fears etc. ) because it will cost them viewership. At that point they’ve put their fame and popularity ahead the best interest of their patients/viewers and they really should trade in their MD degree for a press pass. A year or so back Gupta had an article on CNN where he actually gave some support to the whole vaccine/autism nonsense. He didnt actually come out and support it directly but he left it out there as a possible explanation because he clearly didnt want to offend any of his readers. I think he has a bit more respect for science and reason than Oz but he is treading dangerously close to the line there.

That’s disconcerting because Gupta appears to be the real deal and I hate to see someone sell out for ratings. Hopefully he won’t go down the path to Oz in the future. As to the show, I don’t mind suspending reality for entertainment purposes and cop and hospital shows are just that, not documentaries. But you guys who actually perform the real tasks have a right to be incensed by the blatant innacuracies in the media. Our daughter’s best friend is a forensic investigator and she howls at the innacuracies and elaborate machines that the TV cop shows use in their episodes. My wife and I call them those “spinny things”. Also, the misuse of DNA findings but that’s entertainment, not documentary. The viewing audience needs to know that and not rely on Oz and his ilk to promote fallacies and junk science. Even in my field viewers who tun into the Histpry channel are bombarded with pseudo historic shows and now they have two new blockbusters coming out: Vikings and Bible stories. These will undoubtedly be tauted as a must see show with allusions to reality. I caught a glimpse of the trailers and the Vikings look very much like a biker gang on steroids and a quick shot of good old Noah’s ark swirling around in the sea and a white Jesus talking to one of his disciples in perfect English about how they were going to change the World. This should shoot Greystone’s ratings through the roof. Where’s Charleton Heston when you need him? Since everyone likes realty shows so much how about a reality show about hospitals and actual historical accounts based on evidence, say here’s how the Noah’s ark story began, with the Sumerians or here’s what the Vikings really looked like? Hmm, not as exciting as fantasy? It could be.

But you guys who actually perform the real tasks have a right to be incensed by the blatant innacuracies in the media.
Cap’t Jack

Being a teacher I’m sure you occasionally notice some of the same things in shows that portray teachers and professors. I guess the thing that bothers me most is that for many people these shows are their sole source of information as to what goes on “behind the scenes” in medicine. In fact Gupta is promoting “Monday Mornings” as fiction but a secret look into what goes on in M&M conferences. Its very alluring to people partly because its something that they don’t usually get to see but also because many people think there is something we are hiding from them. Its distressing as a professional because what they show is completely inaccurate and yet people believe it.

I remember one patient of mine, an older woman had watched an episode of ER where a transplant team drops a heart on the floor. Apparently it skids across the floor and under a cabinet where it is then fished out and implanted into the patient. She was very upset and wanted to know how often that sort of thing happens in the OR in real life. I can’t blame her for asking since she has never worked in this field and can’t understand how much is wrong with that scene but I do blame the producers of the show for throwing all sensibility out the window just to create a shocking image. It seems to me there is enough drama in real life that they shouldn’t have to exaggerate and distort things like this to make it interesting.

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For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Being a teacher I’m sure you occasionally notice some of the same things in shows that portray teachers and professors. I guess the thing that bothers me most is that for many people these shows are their sole source of information as to what goes on “behind the scenes” in medicine. In fact Gupta is promoting “Monday Mornings” as fiction but a secret look into what goes on in M&M conferences. Its very alluring to people partly because its something that they don’t usually get to see but also because many people think there is something we are hiding from them. Its distressing as a professional because what they show is completely inaccurate and yet people believe it.

Yes I remember the profusion of teacher shows in the 80’s (e.g. Welcome Back Kotter) grossly distorting the facts and those who believe that teachers merely run a babysitting service and are overpaid. also that we are paid throughout the Summer which we aren’t. Our salaries are based on the number of school days we are in the classroom and when the school isn’t in session, we don’t get paid. So, most teachers have summer jobs to make up the difference. And as to belief, we have far more believers than skeptics. John Q gets his info from TV and the Internet because everything on the Internet is true! Here’s my date, a French model, Bonjooor! I just had a student challenge me over aliens. Her proof was a YouTube video showing a real alien ship!

I haven’t watched many TV shows, (six in total), but I liked House. I obviously know nothing about medicine and my ignorance certainly played a big part in allowing me not having to judge the science part of it, but there was a lot more to House than just the “medical puzzles.” House was based on the idea of Sherlock Holmes (Wilson was Doctor Watson), and just like with Holmes, I find that the details of how the cases were sold were less important than the focus on the behaviour of the the leading character.

And I must say that the show House also seemed more logical—at least to me, a layperson—than stories like The Lord of the Rings, where anything goes: X has more power than Y but only if Y does Z, unless X forgot about A doing B. Fantasy novels make me dizzy.

There are things about House that I could appreciate. Presenting a puzzle and then solving it. Unfortunately is all ends there for those of us who are in the medical field. The show was silly in its execution. House is an extreme example of one of those shows where a single doctor performed the tasks of a dozen specialists. In one show a resident played the role of an internal medicine resident when he admitted a complex diagnostic patient to the hospital, then he became a radiology resident and actually ran the CT machine and read the films, then played the part of a neurosurgeon by doing a brain biopsy and then filled the role of a pathologist by preparing the slides and making a diagnosis based on what he saw. Finally he and House gave the patient the correct treatment only after having given him several incorrect and potentially very harmful treatments before having the results of all their tests back. In real life House would have been in jail after episode one as a result of his depraved indifference to life and his cowboy approach to medicine. Somehow in the series it took until the final season for him to end up behind bars I think.

There actually are places in the country where special teams are set up to try and diagnose difficult cases as is the premise for house but the process is nothing like the way it happens in the TV series. Its very interesting and far more logical than the way that it plays out in House.

You could almost excuse this if it all happened in some back woods location where there was one doctor in the town but it is supposed to take place at a premier academic hospital connected to Princeton med school ( by the way Princeton doesn’t have a med school). In places like that doctors are the complete antithesis of a generalist who can do everything. Specialist reign supreme and someone like House and his residents would never get their hands on a CT machine or a brain biopsy needle.

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For every complex problem there is a solution that is simple, obvious,.... and just plain wrong

Yeah, I realize a radiologist wouldn’t perform a brain surgery (or a brain surgeon wouldn’t run a CT scan), but, again, I didn’t seem much bothered by it in House. I think it would have been difficult (and expensive and probably boring) to stick to reality, just like it would have been tedious if Holmes needed to consult all kinds of people to solve his mysteries.

Good thing you didn’t make it into NASA, macgyver. At least you can enjoy Star Trek.